Unique barriers for parents of children with type 1 diabetes in rural areas
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Parents of children with type 1 diabetes living in rural areas report unique barriers to health care, including distance from support systems, unreliable technology resources and lack of diabetes understanding in the community, data show.
“Individuals in rural areas have decreased life expectancy compared to those living in urban areas, and this gap has widened over time,” Laura Foran Lewis, PhD, RN, assistant professor in the department of nursing at the University of Vermont, Burlington, and colleagues wrote. “Individuals living in rural areas are at increased risk of premature death from all of the five leading causes of death, including heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke.”
This qualitative study, published in The Science of Diabetes Self-Management and Care, included a convenience sample of 11 parents (mean age, 42.6 years) of children diagnosed with type 1 diabetes in the last 10 years who lived in rural Vermont. Researchers conducted interviews about their experiences and analyzed their responses to identify barriers to caring for children with type 1 diabetes in rural areas.
Following interview analysis, researchers identified five themes embodying the experiences of these parents:
- enduring emotional traumas when learning their child’s diagnosis;
- “living life on call” while feeling “isolated” and “living in fear” while holding responsibility for their child’s life;
- adapting to everyday challenges, including extra thought on mealtimes, snacking, eating out, traveling or attending events for their children, as well as adapting education they received about diabetes to real-world settings;
- lacking a safety net for support because their child’s health needs limited child care options, which strains their relationship and needs for self-care, and helping to manage school staff anxiety over diabetes education and care; and
- finding a rhythm after the initial adjustment period and connecting with similarly situated to maintain a positive outlook.
According to the researchers, because this study was limited to parents and children living in Vermont and did not collect data on racial, ethnic and socioeconomic diversity, future studies should explore the needs of other rural communities and explore social determinants of health on parent experiences with type 1 diabetes.
“Diabetes care and education specialists working with families in rural areas should carefully assess barriers that may complicate care and explore ways to provide training and support at the community level to alleviate additional stressors on parents,” the researchers wrote.
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